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KMID : 1195620230160010001
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Clinical and Experimental Otorhinolaryngology
2023 Volume.16 No. 1 p.1 ~ p.19
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Guideline for the Surgical Management of Locally Invasive Differentiated Thyroid Cancer From the Korean Society of Head and Neck Surgery
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Park Jun-Ook
Kim Joo-Hyun
Joo Young-Hoon
Kim Sang-Yeon
Kim Geun-Jeon
Kim Hyun-Bum
Lee Dong-Hyun
Hong Hyun-Jun
Park Young-Min
Jung Eun-Jae
Ji Yong-Bae
Oh Kyoung-Ho
Lee Hyoung-Shin
Lee Dong-Kun
Park Ki-Nam
Ban Myung-Jin
Kim Bo-Hae
Kim Do-Hun
Cho Jae-Keun
Ahn Dong-Bin
Kim Min-Su
Seok Jun-Girl
Jang Jeon-Yeob
Choi Hyo-Guen
Kim Hee-Jin
Park Sung-Joon
Jung Eun-Kyung
Kim Yeon-Soo
Hong Yong-Tae
Lee Young-Chan
Won Ho-Ryun
Shin Sung-Chan
Baek Seung-Kuk
Kwon Soon-Young
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Abstract
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The aim of this study was to develop evidence-based recommendations for determining the surgical extent in patients with locally invasive differentiated thyroid cancer (DTC). Locally invasive DTC with gross extrathyroidal extension invading surrounding anatomical structures may lead to several functional deficits and poor oncological outcomes. At present, the optimal extent of surgery in locally invasive DTC remains a matter of debate, and there are no adequate guidelines. On October 8, 2021, four experts searched the PubMed, Embase, and Cochrane Library databases; the identified papers were reviewed by 39 experts in thyroid and head and neck surgery. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the quality of evidence, and to develop and report recommendations. The strength of a recommendation reflects the confidence of a guideline panel that the desirable effects of an intervention outweigh any undesirable effects, across all patients for whom the recommendation is applicable. After completing the draft guidelines, Delphi questionnaires were completed by members of the Korean Society of Head and Neck Surgery. Twenty-seven evidence-based recommendations were made for several factors, including the preoperative workup; surgical extent of thyroidectomy; surgery for cancer invading the strap muscles, recurrent laryngeal nerve, laryngeal framework, trachea, or esophagus; and surgery for patients with central and lateral cervical lymph node involvement. Evidence-based guidelines were devised to help clinicians make safer and more efficient clinical decisions for the optimal surgical treatment of patients with locally invasive DTC.
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KEYWORD
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Guidelines, Thyroidectomy, Recurrent Laryngeal Nerve, Trachea, Lymph Nodes, Esophagus
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